Restrictive cardiomyopathy resident survival guide: Difference between revisions
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{{familytree | D01 | | D02 | D03 | | | | | |D01=Nininfiltrative|D02=Infiltrative|D03=Storage Disease}} | {{familytree | D01 | | D02 | D03 | | | | | |D01=Nininfiltrative|D02=Infiltrative|D03=Storage Disease}} | ||
{{familytree/end}} | {{familytree/end}} | ||
==Causes== | ==Causes== | ||
===Common Causes=== | ===Common Causes=== | ||
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A complete diagnostic approach should be carried out after a focused initial rapid evaluation is conducted and following initiation of any urgent intervention. | A complete diagnostic approach should be carried out after a focused initial rapid evaluation is conducted and following initiation of any urgent intervention. | ||
{{familytree/start |summary=Sample 1}} | {{familytree/start |summary=Sample 1}} | ||
{{familytree | | | | | | | | A01 |A01=<div style="text-align: left;"><b><u>History and symptoms:</u></b> | {{familytree | | | | | | | | A01 |A01=<div style="text-align: left;"><b><u>History and symptoms:</u></b><br> | ||
❑ Hints for etiology | ❑ Hints for etiology<br> | ||
❑ Duration and onset of illness/symptoms | ❑ Duration and onset of illness/symptoms<br> | ||
❑ Severity and triggers of <b>[[dyspnea]]/[[orthopnea]]</b> and <b> [[fatigue]]/weakness</b>, presence of <b>chest pain</b>, exercise capacity, physical activity, sexual activity (NYHA?) | ❑ Severity and triggers of <b>[[dyspnea]]/[[orthopnea]]</b> and <b> [[fatigue]]/weakness</b>, presence of <b>chest pain</b>, exercise capacity, physical activity, sexual activity (NYHA?)<br> | ||
❑ Weight loss/weight gain ([[cachexia]]/volume overload?) | ❑ Weight loss/weight gain ([[cachexia]]/volume overload?)<br> | ||
❑ <b>Palpitations/(pre)[[syncope]]</b>/[[ventricular tachycardia]]s/[[cardiac arrest]] or [[fibrillation]] | ❑ <b>Palpitations/(pre)[[syncope]]</b>/[[ventricular tachycardia]]s/[[cardiac arrest]] or [[fibrillation]]<br> | ||
❑ Symptoms of [[transient ischemic attack]] or [[thromboembolism]] (anticoagulation necessary?) | ❑ Symptoms of [[transient ischemic attack]] or [[thromboembolism]] (anticoagulation necessary?)<br> | ||
❑ Presence of peripheral [[edema]] or [[ascites]] (volume overload?) | ❑ Presence of peripheral [[edema]] or [[ascites]] (volume overload?)<br> | ||
❑ Problems with breathing at night/ sleep | ❑ Problems with breathing at night/ sleep<br> | ||
❑ Medical history | ❑ Medical history<br> | ||
:❑ Prior hospitalizations | :❑ Prior hospitalizations | ||
:❑ Medication | :❑ Medication<br> | ||
❑ Diet(restriction of sodium and fluid intake?)</div>}} | ❑ Diet(restriction of sodium and fluid intake?)</div>}} | ||
{{familytree | | | | | | | | G01 |G01=<div style="text-align: left;"><b><u>Physical examination:</u></b><br> | {{familytree | | | | | | | | G01 |G01=<div style="text-align: left;"><b><u>Physical examination:</u></b><br> | ||
❑ Vital signs: | ❑ Vital signs:<br> | ||
:❑ Pulse (strength and regularity) | :❑ Pulse (strength and regularity) | ||
:❑ Blood pressure | :❑ Blood pressure | ||
:❑ Respiratory rate<br> | |||
:❑ Respiratory rate | ❑ General appearance:<br> | ||
❑ General appearance: | |||
:❑ BMI(weight loss/weight gain) | :❑ BMI(weight loss/weight gain) | ||
:❑ Peripheral edema | :❑ Peripheral edema | ||
:❑ [[JVD]] may show severity of hemodynamic impairment, most prominent wave is the y descent, jugular venous pulse doesn't fall during inspiration (Kussmaul's sign)<br> | |||
:❑ [[JVD]] may show severity of hemodynamic impairment, most prominent wave is the y descent, jugular venous pulse doesn't fall during inspiration (Kussmaul's sign) | ❑ Heart: <br> | ||
❑ Heart: | |||
:❑ First heart sound is usually normal, and the second heart sound is split normally, | :❑ First heart sound is usually normal, and the second heart sound is split normally, | ||
:❑ Carotid and peripheral pulses may show evidence of a low output<br> | |||
:❑ Carotid and peripheral pulses may show evidence of a low output | ❑ Lungs:<br> | ||
❑ Lungs: | |||
:❑ Rales? | :❑ Rales? | ||
:❑ Pleural effusion? | :❑ Pleural effusion?<br> | ||
❑ Abdomen: | ❑ Abdomen:<br> | ||
:❑ [[Hepatomegaly]], pulsatile liver and/or [[ascites]] (volume overload) <br> | |||
:❑ [[Hepatomegaly]], pulsatile liver and/or [[ascites]] (volume overload) | ❑ Extremities:<br> | ||
❑ Extremities: | |||
:❑ Temperature of lower extremities</div>}} | :❑ Temperature of lower extremities</div>}} | ||
{{familytree | | | | | | | | H01 |H01=A01}} | {{familytree | | | | | | | | H01 |H01=A01}} | ||
{{familytree | | | | | | | | I01 |I01=A01}} | {{familytree | | | | | | | | I01 |I01=A01}} |
Revision as of 19:50, 9 March 2015
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Steven Bellm, M.D. [2]
Restrictive cardiomyopathy resident survival guide Microchapters |
---|
Overview |
Classification |
Causes |
FIRE |
Diagnosis |
Treatment |
Do's |
Dont's |
Overview
Restrictive cardiomyopathy is defined as heart-muscle disease with impaired ventricular filling usually due to increased stiffness. The diastolic volume of either or both ventricles is normal or decreased,the systolic function usually remains normal and wall thickness may be normal or increased. The symptoms and signs may consist of right (jugular venous pressure, peripheral edema, and ascites) or left ventricular failure (breathlessness and evidence of pulmonary edema).[1]
Classification
Restrictive cardiomyopathy | |||||||||||||||||||||||||||||||||||||
Myocardial | Endomyocardial | ||||||||||||||||||||||||||||||||||||
Nininfiltrative | Infiltrative | Storage Disease | |||||||||||||||||||||||||||||||||||
Causes
Common Causes
- Idiopathic cardiomyopathy
- Amyloisosis
- Sarcoidosis
- Endomyocardial fibrosis
- Radiation
- Toxic effects of anthracycline
Complete Diagnostic Approach
A complete diagnostic approach should be carried out after a focused initial rapid evaluation is conducted and following initiation of any urgent intervention.
History and symptoms: ❑ Hints for etiology
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Physical examination: ❑ Vital signs:
❑ General appearance:
❑ Heart:
❑ Lungs:
❑ Abdomen:
❑ Extremities:
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A01 | |||||||||||||||||||||||||||||||||
A01 | |||||||||||||||||||||||||||||||||
B01 | B02 | ||||||||||||||||||||||||||||||||
C01 | |||||||||||||||||||||||||||||||||
D01 | D02 | D03 | |||||||||||||||||||||||||||||||
E01 | E02 | E03 | |||||||||||||||||||||||||||||||
F01 | F02 | ||||||||||||||||||||||||||||||||
Treatment
shown
hidden
Do's
Dont's
References
- ↑ Kushwaha SS, Fallon JT, Fuster V (1997). "Restrictive cardiomyopathy". N Engl J Med. 336 (4): 267–76. doi:10.1056/NEJM199701233360407. PMID 8995091.